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  1. Tom McNicholas
    Tom McNicholas says:

    This is a surprisingly common occurrence and can cause significant morbidity. I do not think your “correct answer” goes far enough. In these days of relatively easily available “bedside” ultrasound machines we should not have to rely on simply “manipulating the catheter into a better position” Why not be certain of the correct positioning by using ultrasound? Well within the competence of most trainees after minimal training. So simple to be sure!

    I would suggest:

    Always ensure urine drains freely before blowing up the catheter balloon.

    Repositioning may help.

    If in any doubt check the balloon is in the bladder by transabdominal ultrasound at the bedside. It is easy to see the catheter in a distended bladder. Then blow up the balloon once you are confident of the position.

    If urethral insertion is difficult get help and/or consider the suprapubic approach (depending on experience).

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